Incidental detection by [C-11]choline PET/CT of meningiomas in prostate cancer patients

Aim Anti-androgenic hormonal therapy in prostate cancer patients with concomitant meningioma may result m tumor growth and development of neurological symptoms. Positron emission tomography/computed tomography (PET/CT) with [C-11]choline is used for restaging prostate cancer patients with biochemical failure. In vitro and in vivo data support altered choline metabolism in meningiomas. Methods. During a retrospective study in prostate cancer patients with biochemical failure referred to our institution between November 2004 and Ja-nuary 2007, encephalic focal uptake of [C-11]choline was incidentally noted in 4 patients, 2 of which had been taking luteinizing hormone-releasing hormone analogs. Results. Subsequent to the incidental finding, one patient underwent surgical removal of the meningioma; strict neuroradiological follow-up was planned for the 3 other patients. Conclusion. We suggest that in prostate cancer patients candidate for anti-androgenic therapy the whole body [C-11]choline PET/CT scan should include the whole skull to check for the possible presence of meningiomas. This could help to identify patients at risk for the development of neurological symptoms during anti-androgenic therapy and help the referring urologist in the clinical management of these patients.